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Successful treatment with erythromycin for idiopathic thrombocytopenic purpura
Masashi Ohe,Satoshi Hashino 대한혈액학회 2011 Blood Research Vol.46 No.2
Macrolides have both immunomodulatory and antibacterial effects. We report 3 cases of primary immune thrombocytopenia (ITP) patients who were successfully treated with macrolides, irrespective of Helicobacter pylori (H. pylori) infection status. Case 1, an 88-year-old woman who was an H. pylori-positive ITP patient, was treated with clarithromycin (CAM). CAM was effective temporarily. As an alternative to CAM, she was successfully treated with erythromycin (EM) for more than 7 months. Case 2, a 61-year-old man who was an H. pylori-negative ITP patient, was unsuccessfully treated with CAM but successfully treated with EM. Case 3, a 75-year-old woman who was a H. pylori-negative ITP patient, was treated with CAM. CAM was effective temporarily. After approximately 6 months, she was treated with EM for a common cold, and her platelet count increased rapidly. Based on these findings, macrolide treatment was effective for ITP. The effectiveness of macrolides might suggest immunomodulatory effects as well as antibacterial effects for H. pylori.
Successful treatment of diffuse large B-cell lymphoma with clarithromycin and prednisolone
Masashi Ohe,Satoshi Hashino,Atsuo Hattori 대한혈액학회 2012 Blood Research Vol.47 No.4
We report a case of diffuse large B-cell lymphoma (DLBCL) treated successfully with clarithromycin (CAM) and prednisolone (PSL). A 71-year-old woman presented with fever and cervical pain. DLBCL was diagnosed based on histological results from lymph node biopsy. Cervical pain was thought to be caused by the invasion of lymphoma cells into the cervical vertebrae. She initially received radiotherapy for the cervical lesion. She did not receive conventional chemotherapy because of the risk of recurrent non-tuberculous mycobacteria infection; therefore, she was treated with 20 mg/day PSL and 800 mg/day CAM to induce apoptosis in lymphoma cells. Complete remission was achieved after 6 months. The present findings suggest that CAM and PSL may be effective in some cases of DLBCL.
A case of follicular B-cell lymphoma treated using clarithromycin
Masashi Ohe,Satoshi Hashino 대한혈액학회 2011 Blood Research Vol.46 No.3
We report a case of follicular B-cell lymphoma (FL) treated successfully using clarithromycin (CAM). A 44-year-old man who presented with lymphadenopathy was diagnosed with FL after a histological examination of his biopsy specimens. He was administered chemotherapy with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) following which stable disease was achieved. However, the subsequent clinical course showed partial remission of FL and stable disease with tumor regrowth, each of which was treated with chemotherapeutic regimens. Since the patient was diagnosed with leukocytopenia, he could not undergo chemotherapy for the third regrowth; hence, he was administered CAM. His lymphadenopathy regressed and the levels of soluble interleukin 2-receptor decreased. This case shows that treatment using CAM may be effective in some cases of FL.
A Case of Paraneoplastic Syndrome
Masashi Ohe 순천향대학교 순천향의학연구소 2014 Journal of Soonchunhyang Medical Science Vol.20 No.2
A 73-year-old woman was admitted with fever, arthralgia, and swelling of the hands and feet. She was diagnosed with remitting seronegative symmetrical synovitis with pitting edema (RS3PE) accompanied by breast carcinoma, a type of paraneoplastic syndrome. Treatment with acetaminophen and diclofenac sodium for fever and arthralgia proved minimally effective. She experienced great difficulty in walking and grasping smoothly due to edema; therefore, clarithromycin (CAM) was added in expectation of its anti-inflammatory effects. About 10 days after starting CAM treatment, pitting edema improved considerably. Fever and arthralgia did not improve satisfactorily after resection of breast carcinoma, and thus she was successfully treated with low-dose prednisolone (PSL). This case suggests that other than surgical resection of the neoplasm, CAM and PSL treatment for RS3PE associated with neoplastic disease may be effective.